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Objectives: The aim of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) was to develop an updated Guideline for the diagnostic assessment of stress urinary incontinence (SUI) in women. Material and methods: Earlier PSGO guidelines and the literature about the diagnostic assessment of SUI, including current international guidelines, were reviewed. Results: As in the earlier guidelines, the diagnostic process was subdivided into the initial and the specialized diagnostics. Patients who required specialized diagnostic testing were identified. Functional diagnostic tests, performed by physiotherapists, were included. Attention was paid to new diagnostic possibilities. Conclusions: Initial diagnostic assessment is sufficient to devise the optimal treatment plan in a number of patients. It also allows to identify which patients will require specialized diagnostics, whose scope is individually tailored to the patient needs and depends on symptom complexity, surgical history, treatment plan, experience of the physician, availability of the equipment, and cost-effectiveness ratio. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder is a female affective disorder that is defined by mood symptoms. The condition is linked to unstable progesterone concentrations. Progestin supplementation is given in cases of threatened or recurrent miscarriage and for luteal phase support. Progesterone is essential for implantation, immune tolerance, and modulation of uterine contractility. For a long time, the administration of progestins was associated with an unfavorable impact on mood, leading to negative affect, and, therefore, was contraindicated in existing mood disorders. Establishing the role of the natural progesterone derivative allopregnanolone in advances in the treatment of postpartum depression has shed new light on the general pathophysiology of mood disorders. Allopregnanolone directly interacts with gamma-aminobutyric acid type A (GABA-A) receptors even at nanomolar concentrations and induces significant anti-depressant, anti-stress, sedative, and anxiolytic effects. Postpartum depression is caused by a rapid drop in hormones and can be instantly reversed by the administration of allopregnanolone. Premenstrual dysphoric disorder can also be considered to result from insufficient neuroactive steroid action due to low progesterone derivative concentration, unstable hormone levels, or decreased receptor sensitivity. The decrease in progesterone levels in perimenopause is also associated with affective symptoms and an exacerbation of some psychosomatic syndromes. Bioidentical progesterone supplementation encounters several obstacles, including limited absorption, first-pass effect, and rapid metabolism. Hence, non-bioidentical progestins with better bioavailability were widely applied. The paradoxical, unfavorable effect of progestins on mood can be explained by the fact that progestins suppress ovulation and disturb the endocrine function of the ovary in the luteal phase. Moreover, their distinct chemical structure prevents their metabolism to neuroactive, mood-improving derivatives. A new understanding of progesterone-related mood disorders can translate the study results from case series and observational studies to cohort studies, clinical trials, and novel, effective treatment protocols being developed. [ABSTRACT FROM AUTHOR]

Author(s): Didier Ndeh; Artur Rogowski; Alan Cartmell; Ana S. Luis; Arnaud Basl; Joseph Gray; Immacolata Venditto; Jonathon Briggs; Xiaoyang Zhang; Aurore Labourel; Nicolas Terrapon; Fanny Buffetto; Sergey Nepogodiev; Yao Xiao; [...]

The metabolism of carbohydrate polymers drives microbial diversity in the human gut microbiota. It is unclear, however, whether bacterial consortia or single organisms are required to depolymerize highly complex glycans. Here we show that the gut bacterium Bacteroides thetaiotaomicron uses the most structurally complex glycan known: the plant pectic polysaccharide rhamnogalacturonan-II, cleaving all but 1 of its 21 distinct glycosidic linkages. The deconstruction of rhamnogalacturonan-II side chains and backbone are coordinated to overcome steric constraints, and the degradation involves previously undiscovered enzyme families and catalytic activities. The degradation system informs revision of the current structural model of rhamnogalacturonan-II and highlights how individual gut bacteria orchestrate manifold enzymes to metabolize the most challenging glycan in the human diet., Author(s): Didier Ndeh [1]; Artur Rogowski [1]; Alan Cartmell [1]; Ana S. Luis [1]; Arnaud Basl [1]; Joseph Gray [1]; Immacolata Venditto [1]; Jonathon Briggs [1]; Xiaoyang Zhang [1]; Aurore [...]

Objectives: The aim of the team appointed by the Board of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) was to develop this interdisciplinary Guideline for the diagnostic assessment of pelvic organ prolapse (POP) in women, based on the available literature, expert knowledge and opinion, as well as everyday practice. Material and methods: A review of the literature, including current international guidelines and earlier PSGO recommendations (2010-2020) about POP, was conducted. Results: The steps of the diagnostic assessment for patients with POP, subdivided into initial and specialized diagnostics, have been presented. Indications for specialized diagnostic assessment have also been listed. In case of surgical treatment, the patient may be referred solely based on the initial diagnostics or after certain elements of the specialized diagnostics have been completed. Conclusions: Due to inconclusive data, the scope of the diagnostic process for POP is individualized for each patient and depends on patient-reported symptoms, initial diagnostic findings, surgical history, management plan, availability of the equipment, and cost. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the publication was to present the Guideline of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the management of recurrent pelvic organ prolapse, based on the available literature, expert knowledge and opinion, as well as everyday practice. Material and methods: In 2005, 2006 and 2010, the panel of PSGO experts published guidelines for the diagnosis and treatment of patients with lower urinary tract symptoms (LUTS). This publication presents an update of those recommendations and concerns recurrent POP treatment. Main conclusion: The analysis of data revealed that sacrocolpopexy with the use of commercial sets or polypropylene hernia mesh is the method of choice for the surgical repair of recurrent vaginal vault prolapse. However, a significantly higher risk of surgical and postoperative complications after sacrocolpopexy, as compared to vaginal surgeries, should be considered when making treatment decisions. In other types of recurrent POP, the choice of surgery method should be tailored to the individual needs of each patient and may depend on the medical center. [ABSTRACT FROM AUTHOR]

Objectives: The aim was to present an interdisciplinary Guideline of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the management of stress urinary incontinence (SUI). Material and methods: A review of the literature, including current international guidelines and earlier recommendations of the PSGO Urogynecology Section, about the treatment of SUI was conducted. Results: Management of SUI is presented. Four lines of therapy were identified: line 1 -- the so-called 'conservative treatment', which should always be attempted, regardless of SUI symptom severity; line 2 -- surgical intervention; lines 3 and 4 -- reoperations after unsuccessful surgeries from line 2. The literature reports which provided supporting evidence for this Guideline, including the practical aspects, were discussed. Conclusions: A systematic review of the guidelines and an analysis of SUI management were conducted. The need for an individualized approach was emphasized. [ABSTRACT FROM AUTHOR]

Objectives: The aim was to present an interdisciplinary Guideline of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the use of urodynamics (UDS) in the diagnostic process of patients with lower urinary tract symptoms (LUTS) based on the available literature, expert knowledge, and everyday practice. Material and methods: A review of the literature concerning the use of UDS in women, including current international guidelines and earlier recommendations of the PSGO Urogynecology Section, was conducted. Results: Urodynamic testing allows to make the urodynamic diagnosis which, nevertheless, remains to be the preliminary diagnosis. Medical history, physical examination, and detailed analysis of the previous test results (laboratory, imaging, endoscopic) need to be taken into consideration before making the final diagnosis. Urodynamic testing before surgical treatment of SUI is allowable, but the decision remains at the discretion of the physician. Urodynamic testing is not necessary before primary surgical treatment of uncomplicated SUI, but it has been demonstrated to optimize the therapeutic methods in complicated SUI. The significance of UDS in the diagnostic process of patients with overactive bladder symptoms, voiding dysfunction, and bladder outlet obstruction was discussed. Conclusions: Urodynamic testing is a vital element of the urogynecological diagnostic process. The scope of UDS should reflect the individual needs and symptoms of each patient and be based on the current guidelines, expert knowledge and experience of the physician, indications, and eligibility, as well as additional test results of the affected patients. Due to formal and legal requirements, PSGO, in this Guideline, wishes to emphasize the need for an individualized approach to both, test performance and result interpretation. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the publication was to present the interdisciplinary guidelines of the Urogynecology Section of the Polish Society of Gynecologists and Obstetricians (PSGO) for the treatment of overactive bladder (OAB) syndrome based on the available literature, expert knowledge, and everyday practice. Material and methods: A review of the literature, including current recommendations for the treatment of overactive bladder syndrome, urinary incontinence, urgency and mixed urinary incontinence, as well as the earlier recommendations of the PSGO Urogynecology Section, was conducted. Results: Management of the patients with OAB is presented. Four lines of therapy were identified: 1) educating the patient, behavioral therapy with pelvic floor muscle training, 2) pharmacotherapy, 3) botulinum toxin injection and tibial nerve stimulation; and sacral nerve stimulation even though so far it has been used only in selected populations, 4) surgical intervention. The literature reports which provided supporting evidence and presented various aspects of the therapy were discussed. OAB pharmacotherapy-related issues which are vital in everyday clinical practice were presented. Conclusions: A systematic review of the available guidelines and an analysis of OAB (including urgency urinary incontinence) management were conducted. The Polish Society of Gynecologists and Obstetricians issued the guidelines for the therapeutic management of OAB patients. The need for an individualized approach was emphasized. [ABSTRACT FROM AUTHOR]

Copyright of Ginekologia i Perinatologia Praktyczna is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ginekologia i Perinatologia Praktyczna is the property of VM Medica-VM Group (Via Medica) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Current Neurology / Aktualno?ci Neurologiczne is the property of Medical Communications Sp. z o.o. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A predictive model for family 6 carbohydrate binding modules (CBMs) (CBM6) that is based upon several factors, including phylogenetic relatedness, and structural and functional evidence is presented. The mechanism, by which the CBM recognizes xylose but not glucose, a specificity not known earlier in family 6 CBM supported the predictive model that holds that variation in region E plays a key role in the diverse ligand selection evident in CBM6.

Microbial degradation of plant cell walls is a central component of the carbon cycle and is of increasing importance in environmentally significant industries. Plant cell wall-degrading enzymes have a complex molecular architecture consisting of catalytic modules and, frequently, multiple non-catalytic carbohydrate binding modules (CBMs). It is currently unclear whether the specificities of the CBMs or the topology of the catalytic modules are the primary drivers for the specificity of these enzymes against plant cell walls. Here, we have evaluated the relationship between CBM specificity and their capacity to enhance the activity of GH5 and GH26 mannanases and CE2 esterases against intact plant cell walls. The data show that cellulose and mannan binding CBMs have the greatest impact on the removal of mannan from tobacco and Physcomitrella cell walls, respectively. Although the action of the GH5 mannanase was independent of the context of mannan in tobacco cell walls, a significant proportion of the polysaccharide was inaccessible to the GH26 enzyme. The recalcitrant mannan, however, was fully accessible to the GH26 mannanase appended to a cellulose binding CBM. Although CE2 esterases display similar specificities against acetylated substrates in vitro, only CjCE2C was active against acetylated mannan in Physcomitrella. Appending a mannan binding CBM27 to CjCE2C potentiated its activity against Physcomitrella walls, whereas a xylan binding CBM reduced the capacity of esterases to deacetylate xylan in tobacco walls. This work provides insight into the biological significance for the complex array of hydrolytic enzymes expressed by plant cell wall-degrading microorganisms. [ABSTRACT FROM AUTHOR]

Cell wall degrading enzymes have a complex molecular architecture consisting of catalytic modules and noncatalytic carbohydrate-binding modules (CBMs). The function of CBMs in cell wall degrading processes is poorly understood. Here, we have evaluated the potential enzymetargeting function of CBMs in the context of intact primary and secondary cell wall deconstruction. The capacity of a pectate lyase to degrade pectic homogalacturonan in primary cell walls was potentiated by cellulose-directed CBMs but not by xylan-directed CBMs. Conversely, the arabinofuranosidase-mediated removal of side chains from arabinoxylan in xylan-rich and cellulose-poor wheat grain endosperm cell walls was enhanced by a xylan-binding CBM but less so by a crystalline cellulose-specific module. The capacity of xylanases to degrade xylan in secondary cell walls was potentiated by both xylanand cellulose-directed CBMs. These studies demonstrate that CBMs can potentiate the action of a cognate catalytic module toward polysaccharides in intact cell walls through the recognition of nonsubstrate polysaccharides. The targeting actions of CBMs therefore have strong proximity effects within cell wall structures, explaining why cellulosedirected CBMs are appended to many noncellulase cell wall hydrolases. [ABSTRACT FROM AUTHOR]

The primary aim of the study was to translate and validate a Polish version of the CONTILIFE, a quality of life questionnaire. The clinical validity of the CONTILIFE was assessed against the number of urinary leaks, Valsalva leak point pressure (VLPP), and maximum urethral closure pressure (MUCP). One hundred women with stress urinary incontinence completed a Polish version of the CONTILIFE twice with a 4-day interval. Internal consistency (Cronbach’s α= 0.94) and test–retest reliability of the instrument (ICC = 0.96) were very good. A significant relationship was found between all the CONTILIFE dimension scores, the CONTILIFE global score, and the number of urinary leaks per week. A less significant relationship was found between VLPP, MUCP, and CONTILIFE dimension and global scores. A Polish version of the CONTILIFE can be a reliable measure of quality of life in stress urinary incontinence patients. [ABSTRACT FROM AUTHOR]

(1) Background: Overactive bladder (OAB) symptoms are frequently present in women with pelvic organ prolapse (POP). Although urinary nerve growth factor (NGF) is a promising biomarker of OAB, little is known about its role in patients with OAB secondary to POP. The aim of the study was to evaluate urinary NGF levels in patients with POP involving the anterior vaginal wall and check if it may serve as a predicting factor for postoperative resolution of OAB symptoms. (2) Methods: Eighty-three Caucasian women included in the study were divided into three groups: pure OAB, one associated with POP (POP&OAB) and a control group composed of healthy volunteers. The urine NGF and creatinine were assessed with ELISA tests to calculate the NGF/creatinine ratio. (3) Results: The NGF/creatinine ratio was significantly higher in patients with pure OAB in comparison with other groups; however, it did not differ between the control group and the POP&OAB group. There was no correlation between NGF/creatinine ratio and age, menopausal status, BMI, parity or urodynamic findings. The NGF/creatinine ratio was not a prognostic factor for OAB symptoms' resolution after surgical treatment of POP. (4) Conclusions: Urinary NGF excretion is not increased in women with OAB secondary to POP; thus, it may not serve as an OAB biomarker in these patients. [ABSTRACT FROM AUTHOR]

Alcohol-related cues may induce relapse to heavy alcohol drinking and promote molecular adaptations in discrete brain regions. An exact nature of these molecular alterations is still unknown. In the present study, rats trained to self-administer ethanol were tested for cue-induced reinstatement of ethanol seeking after 30 days of abstinence. Next, a detailed immunocytochemical analysis of c-Fos activation was performed within seven nuclei of the amygdala. In the second experiment, c-Fos activation after reinstatement of ethanol seeking induced by discrete cues was compared with the activation pattern of its putative partner (c-Jun) and regulators (extracellular signal-regulated kinases and c-Jun N-terminal kinases). Reexposure to ethanol-associated context cues (an extinction session) potentiated c-Fos expression within the basolateral and central amygdala. Repeated presentation of ethanol-associated discrete cues in an extinction/reinstatement session led to even stronger c-Fos activation in the latter nuclei. In the second experiment, reexposure to the ethanol-associated context and discrete cues activated both c-Jun and extracellular signal-regulated kinases (ERK1/2) in the basolateral amygdala. Our observations suggest that the basolateral and central amygdala may be specifically involved in alcohol-seeking behavior induced by discrete cues.Neuropsychopharmacology (2008) 33, 1835–1846; doi:10.1038/sj.npp.1301567; published online 12 September 2007 [ABSTRACT FROM AUTHOR]

— Aims: To characterize the relationship between the sucrose- and ethanol-reinforced behaviour in Wistar rats. Methods: Subjects (n = 31) were trained to lever press for 8% (v/v) ethanol in an operant procedure where increasing concentrations of ethanol were introduced in the presence of 8% (w/v) sucrose. The sucrose concentration was subsequently decreased from 8 to 0%. Subjects were allowed to stabilize their intake of 8% ethanol over the next 20 days. Results: Self-administration of 8% sucrose (ml/kg) significantly correlated with ethanol consumption (g/kg) on days 1–5 of the 8% ethanol self-administration period. This relationship completely disappeared during the subsequent weeks of ethanol self-administration (days 6–20). Conclusions: The results of the present study, combined with our previous findings, may indicate that self-administration of sucrose predicts only the initial phase of ethanol-taking behaviour in Wistar rats. [ABSTRACT FROM PUBLISHER]

Introduction and hypothesis: A link between psychiatric comorbidities and overactive bladder symptomatology has been suggested by preclinical and clinical studies. Given this, we hypothesized that a psychiatric history and current treatment with psychotropic medications could be related to the severity of overactive bladder and incontinence symptoms in patients referred to a tertiary care urogynecological center. Methods: One hundred and twenty-seven female patients diagnosed with an overactive bladder were screened for a lifetime history of psychiatric disorders and the type and number of psychotropic medications currently taken. The overall severity of overactive bladder symptoms was assessed using the Indevus Urgency Severity Scale. The severity and impact of urinary incontinence on the quality of life were quantified with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Urinary incontinence was further quantified with the aid of the Urinary Distress Inventory-6. The patients were screened for stress urinary incontinence using the Stamey Incontinence Score. Results: A psychiatric history, as well as current use of at least two psychotropic medications, was associated with increased severity of overactive bladder symptoms. A history of depression and current treatment with any selective serotonin reuptake inhibitor was associated with increased severity of stress urinary incontinence symptoms. Current treatment with other psychotropic medications, including sedative-hypnotics and drugs with anticholinergic properties was not related to the severity of overactive bladder and incontinence symptoms. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if asiatic acid may act efficiently in the model of cyclophosphamide (CYP)-induced cystitis in rats. We performed experiments after administration of CYP (single dose 200 mg/kg, intraperitoneally), asiatic acid (30 mg/kg/day for 14 consecutive days, by oral gavage), or CYP plus asiatic acid, during which conscious cystometry, measurements of urothelium thickness and bladder edema, as well as selected biomarkers analyses were conducted. In rats that received asiatic acid together with CYP, a drop in bladder basal pressure, detrusor overactivity index, non-voiding contraction amplitude, non-voiding contraction frequency, and the area under the pressure curve were observed, when compared to the CYP group. Furthermore, a significant increase in threshold pressure, voided volume, intercontraction interval, bladder compliance, and volume threshold to elicit NVC were found in that group accordingly. Administration of the asiatic acid successfully restored concentrations of biomarkers both in bladder urothelium (BDNF, CGRP, OCT-3, IL-1β, IL-6, NGF, nitrotyrosine, malondialdehyde, TNF-α, SV2A, SNAP23, SNAP25, PAC-1, ORM1, occludin, IGFBP-3, HB-EGF, T–H protein, Z01, and HPX) and detrusor muscle (Rho kinase and VAChT) in CYP-treated rats. Finally, asiatic acid significantly decreased urothelium thickness and bladder oedema. Asiatic acid proved to be a potent and effective drug in the rat model of CYP-induced cystitis. [ABSTRACT FROM AUTHOR]

Overactive Bladder (OAB) is a common condition that is known to have a significant impact on daily activities and quality of life. The pathophysiology of OAB is not completely understood. One of the new hypothetical causative factors of OAB is dysbiosis of an individual urinary microbiome. The major aim of the present review was to identify data supporting the role of bacterial colonization in overactive bladder symptoms in children and adolescents. The second aim of our study was to identify the major gaps in current knowledge and possible areas for future clinical research. There is a growing body of evidence indicating some relationship between qualitative and quantitative characteristics of individual urinary microbiome and OAB symptoms in adult patients. There are no papers directly addressing this issue in children or adolescents. After a detailed analysis of papers relating urinary microbiome to OAB, the authors propose a set of future preclinical and clinical studies which could help to validate the concept in the pediatric population. [ABSTRACT FROM AUTHOR]

Surgical treatment is the most important part of therapy for endometrial cancer. The aim of the study was to define factors having the most significant impact on surgical treatment of endometrial cancer when using traditional and laparoscopic methods. In the study, we evaluated 75 females who were treated for endometrial cancer via laparoscopic surgery in 2019 and used a historical control of 70 patients treated by laparotomy in 2011. The evaluated risk factors included the method of surgery, type of lymphadenectomy, patient's age, various obesity parameters, histological grading, cancer clinical staging, pelvic dimensions, previous abdominal surgeries, comorbidities, and number of deliveries. The duration of hospitalization, operation time, loss of hemoglobin, and procedure-related complications were used as parameters of perioperative outcomes. Multivariable linear regression analysis confirmed the following factors as being predictors of worse perioperative outcomes: laparotomy, abdominal obesity (waist circumstance and waist-to-hip ratio), range of lymphadenectomy, prior abdominal surgeries, and larger pelvic dimensions. Abdominal obesity is a significant risk factor in the treatment of endometrial cancer. Laparotomy continues to be utilized frequently in the management of endometrial cancer in Poland as well as elsewhere, and adopting a minimally invasive approach is likely to be beneficial for patient outcome. [ABSTRACT FROM AUTHOR]